2012-05-15T08:33:20-05:00 2011-06-30 Arnett & Foster PLLC P O Box 2629 Charleston WV 25329 990 2010-07-01 550492006 West Virginia University Medical Corporation WEST 3042857124 PO Box 897 Morgantown WV 265070897 JUDIE CHARLTON 3042857124 2012-05-14 1 Harry C Harless 3043460441 2010 2016-02-24 21:20:13Z University Health Associates Judie Charlton MD PO Box 897 Morgantown WV 265070897 250469797 0 X N/A X 1971 WV To support the West Virginia University School of Medicine in the furtherance of its charitable, scientific, and educational purposes by serving as its faculty practice plan and providing a full range of business management services to its faculty in support of their clinical practices. 8 0 1896 0 0 0 0 0 237938224 248402259 -203700 824765 0 0 237734524 249227024 11594264 17319145 0 0 166139672 173636461 0 0 0 51017192 53268028 228751128 244223634 8983396 5003390 81445904 101161542 44988209 59758807 36457695 41402735 X To support the West Virginia University School of Medicine in the furtherance of its charitable, scientific, and educational purposes by serving as its faculty practice plan and providing a full range of business management services to its faculty in support of their clinical practices. 0 0 222797251 17319145 248382193 The Corporation supported faculty physicians of the West Virginia University School of Medicine in their provision of medical services with approximately 579,726 patient visits during the year ended June 30, 2011. The Corporation continuously meets its exempt purpose by providing funds to the state-supported West Virginia School of Medicine. By providing these funds, the Corporation has both lessened the burdens to government and advanced graduate medical education in West Virginia. As part of its mission to support the School of Medicine, the Corporation incurred expenditures for professional liability premiums on behalf of the faculty physicians of the School of Medicine. The Corporation has also lessened the burdens on government by relieving poverty in West Virginia by supporting the faculty physicians in their provision of charity care. 222797251 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 186 0 1 1896 1 0 0 0 0 0 0 0 0 0 0 X 8 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 X Kelly A Henderson 3042857122 255 Scott Avenue Morgantown WV 265070897 Arthur Ross III MD 40.00 X 107006 0 8365 Michael Hurst MD 40.00 X 260822 0 32377 Karen MacKay MD 40.00 X 178094 0 14450 Sanford Emery MD 40.00 X 500557 0 32377 Norman Ferrari III MD 40.00 X 247538 0 27830 Ronald Pellegrino MD 40.00 X 121821 0 10289 Lakshmikumar Pillai MD 40.00 X 261182 0 29682 Ansaar Rai MD 40.00 X 390290 0 38047 Judie Charlton MD 40.00 X 307577 0 31693 Mitchell Harris 50.00 X 291756 0 47136 Mary Jo Shahan 50.00 X 0 270234 15791 Mathis P Frick MD 40.00 X 645655 0 32377 James E Brick MD 40.00 X 326281 0 32377 David Brisell 40.00 X 227317 0 30752 Robert Schreiber 40.00 X 174837 0 23566 Julian Bailes MD 40.00 X 1005147 0 32377 Ronald Hargraves MD 40.00 X 658653 0 33047 Robert Beto II MD 40.00 X 637242 0 32377 John Collins MD 40.00 X 556821 0 32377 Charles Rosen MD 40.00 X 547265 0 32377 7445861 270234 569664 406 0 1 0 Epic Systems Corporation 1979 Milky Way Verona WI 53593 Billing Software Maintenance 1034778 Patton Building Services 956 Chestnut Ridge Road Morgantown WV 26505 Janitorial Services 491378 Danhill Construction Company PO Box 685 Gauley Bridge WV 26085 Building Contractor 488960 Sutter Roofing & Metal Company 2 Stadium Drive Clarksburg WV 26301 Building Contractor 288819 Landau Building Company 9855 Rinaman Road Wexford PA 15090 Building Contractor 277120 17 Direct patient care 621110 185868404 185868404 Expense reimbursements 621110 33505598 33505598 Other health care 621110 28520593 28520593 Rent-Physician office 531120 390614 390614 School of Oman 531120 62604 62604 54446 34380 20066 248402259 254729 254729 1312809 500000 1242773 70036 500000 570036 570036 249227024 248382193 0 844831 17319145 17319145 4454924 3330146 1124778 142977807 133980312 8997495 11516822 10723667 793155 8175437 6802763 1372674 6511471 5861070 650401 11 11 126922 126922 17273 17273 3160189 1081671 2078518 485583 72730 412853 10590048 8798193 1791855 5482187 4659859 822328 3780815 3591774 189041 1295307 1195886 99421 559056 522090 36966 1015283 1015283 6649386 5984447 664939 4071064 3438932 632132 Provision for bad debts 11125792 11125792 Dues, memberships, lice 1770169 1563954 206215 Maintenance and repairs 1685410 1538890 146520 Recruitment 709105 536445 172660 In-house training & dev 180500 179255 1245 563928 490230 73698 244223634 222797251 21426383 0 8471 9175 24560115 42781181 17585715 17575202 56153 69344 295611 341344 62291104 34701178 29838497 27589926 2836850 3092216 6264492 9703154 81445904 101161542 25046983 28282225 51540 50 19125278 26963162 764408 4513370 44988209 59758807 X 36457695 41402735 36457695 41402735 81445904 101161542 X 5003390 -58350 X X 0 1 1 X 0 X 190057 190057 34069309 18359115 15710194 27830511 16314491 11516020 201227 27572 173655 27589926 Due from affiliates 2491393 Other receivables 6348716 Due from physicians 764332 Bond issue costs 98713 9703154 Due to affiliates 4513370 4513370 249227024 244223634 5003390 -58350 -58350 4945040 215721426 0 215721426 33505598 33505598 249227024 210718036 0 210718036 33505598 33505598 244223634 Part XII, Line 4b - Other Adjustments: Expense reimbursements netted in financial statements 33,505,598. Part XIII, Line 4b - Other Adjustments: Expense reimbursements netted in financial statements 33,505,598. 0 West Virginia University School of Medicine 1150 HSN PO Box 9100 Morgantown WV 26506 556000842 3 17319145 To support the WVU School of Medicine. X X X X 0 0 0 0 0 1 1 0 0 Michael Hurst MD 247563 0 13259 0 0 0 32377 0 3417 0 296616 0 0 0 Karen MacKay MD 146281 0 31813 0 0 0 14450 0 2664 0 195208 0 0 0 Sanford Emery MD 490578 0 9979 0 0 0 32377 0 3960 0 536894 0 0 0 Norman Ferrari III MD 241279 0 6259 0 0 0 27830 0 3303 0 278671 0 0 0 Lakshmikumar Pillai MD 229076 0 32106 0 0 0 29682 0 3546 0 294410 0 0 0 Ansaar Rai MD 319447 0 70843 0 0 0 32377 0 10716 0 433383 0 0 0 Judie Charlton MD 298732 0 8845 0 0 0 29434 0 7305 0 344316 0 0 0 Mitchell Harris 282756 0 9000 0 0 0 32377 0 18663 0 342796 0 0 0 Mary Jo Shahan 0 235551 0 27527 0 7156 0 15680 0 111 0 286025 0 0 Mathis P Frick MD 517893 0 127762 0 0 0 32377 0 5046 0 683078 0 0 0 James E Brick MD 326281 0 0 0 0 0 32377 0 5046 0 363704 0 0 0 David Brisell 201554 0 25763 0 0 0 25027 0 8551 0 260895 0 0 0 Robert Schreiber 157750 0 17087 0 0 0 18300 0 7792 0 200929 0 0 0 Julian Bailes MD 945897 0 59250 0 0 0 32377 0 5046 0 1042570 0 0 0 Ronald Hargraves MD 611653 0 47000 0 0 0 32377 0 4216 0 695246 0 0 0 Robert Beto II MD 567242 0 70000 0 0 0 32377 0 5046 0 674665 0 0 0 John Collins MD 513339 0 43482 0 0 0 32377 0 3546 0 592744 0 0 0 Charles Rosen MD 493784 0 53481 0 0 0 32377 0 5280 0 584922 0 0 0 Mary Jo Shahan - CAA $15,680 Part I, Line 6 Year-end incentives for management are based on the bottom line performance of the organization as a whole. West Virginia Hospital Finance Authority 621256910 2008-07-08 7000000 Clinical information system 0 0 0 City of Ranson 556000880 2011-02-03 1800000 Medical office building 0 0 0 West Virginia Hospital Finance Authority 621256910 2011-06-30 8815000 Refinance physician office center 0 0 0 7000000 7000000 2009 0 0 1 1 1465348 1465348 2011 0 0 1 1 8815000 89364 8815000 2011 1 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 0 0 1 0.00000 0.00000 0.00000 0 0 0 0 0 1 0.00000 0.00000 0.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 Form 990, Part VI, Section A, line 6 Membership in the Corporation is limited to physicians and surgeons licensed to practice medicine in West Virginia. Corporation members are Clinical Department physician faculty members of the West Virginia University School of Medicine. Each member occupies one of the following categories: 1) Voting ("Full-time") faculty members 2) Non-Voting ("Part-time") faculty members Form 990, Part VI, Section A, line 7a There are eight voting members of the Corporation's board of directors. Seven are elected from and by the full-time physician faculty members of the Corporation. The eighth is the Dean of the West Virginia University School of Medicine, who is an ex-officio voting member. Form 990, Part VI, Section A, line 7b Proposed revisions to the by-laws are subject to approval by majority vote of the Board. Such revisions are then subject to approval by two thirds (2/3) of full-time faculty members present in person or by written proxy at a regular or duly called special meeting of the Corporation, and shall be effective when approved by the President of West Virginia University. Form 990, Part VI, Section B, line 11 Form 990 is prepared by the Corporation's independent accountants, with assistance from the Corporation's Controller. Before the 990 is filed with the IRS, the CFO and the Controller review the 990 with the Finance Committee and Board members to ensure they have an understanding of the information provided on the form. Form 990, Part VI, Section B, line 12c Annually, employees and physicians are required to answer questions regarding any potential conflicts of interest. The Human Resources department reviews the reports for any discrepancies and follows up as necessary. Form 990, Part VI, Section B, line 15 A compensation committee reviews performance, goals, and comparable market data to determine compensation for the officers and key employees. Form 990, Part VI, Section C, line 18 The organization's Form 1023 and Form 990 are available to the public upon request. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -58,350. Clarification of 'yes' response Form 990, Part XII The finance committee of the board oversees the audit. This has not changed since the prior year. Hospital Schedule H Although the organization qualifies as a hospital under IRC Section 170(b)(1)(A)(iii) as shown on Schedule A item 3, the organization does not qualify as a hospital for Schedule H or State of West Virginia purposes. West Virginia University School of Medicine PO Box 9100 Morgantown WV 265069600 556000842 Medical education WV 501(c)3 2 N/A 0 West Virginia University Dental Corporation PO Box 1587 Morgantown WV 265071587 550524309 Dental services WV 501(c)3 2 N/A 0 West Virginia University Hospitals Inc PO Box 8034 Morgantown WV 265068034 550643304 Hospital WV 501(c)3 3 N/A 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 West Virginia University Hospitals Inc I 390614 FMV - cash paid